Individual
MRS. MARION SHARON CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTAL
Contact information
Practice address
1025 N COUNTRY CLUB DR, MESA, AZ 85201-3307
(480) 472-6162
Mailing address
602 E STONEBRIDGE DR, GILBERT, AZ 85234-6435
(480) 820-3970
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0086
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
580242
—
AZ
Enumeration date
01/08/2007
Last updated
07/08/2007
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